Impact of covid-19 epidemic and large-scale emergency vaccination on the concept and experience of routine immunization among children's parents

Objective To understand the impact of Coronavirus disease 2019 (COVID-19) epidemic and mass emergency vaccination on parents' perception and experience of immunization. Methods From May 6, 2021 to June 20, 202l, an online questionnaire survey was conducted among 4 171 parents of children using the mobile APP of vaccination service in Guangzhou. Results Of all the respondents, 1 911 of them (45.8%) agreed with the suspension of routine immunization measures during the COVID-19 epidemic, and 1 508 respondents (36.2%) would actively postpone child immunization even if the vaccination clinic was not stopped during the COVID-19 epidemic. 2 959 (70.9%), 2 558 (61. 3%) and 2 399 (57. 5%)respondents were satisfied with the protective measures, on-site order and service quality a ter the resumption of vaccination, respectively. 3 437 respondents (82. 4%) indicated that the COVID-19 epidemic had enhanced their attention to vaccination. A total of 1 415 (33.9%) parents of children said that the discontinuation of vaccination clinics weakened their attention to the timeliness of vaccination, and 1 380 (33.1%) parents agreed that "the postponement of vaccination will not affect the vaccination effect”. Compare to parents with higher education (university or above), parents with young children, parents with secondary education (below university), and parents with older children who were older in age themselves were relatively satisfied with the various protective measures taken by vaccination units during the period of suspension of vaccination clinics and the resumption of vaccination. They believed that the field order and the quality of vaccination service were improved. They were more sensitive to the COVID-19 epidemic and tend to actively delay vaccination. They pay more attention to the importance and timeliness of vaccination, and were vulnerable to the impact of COVID-19 epidemic and medical suspension. Due to the COVID-19 epidemic and the control measures after the resumption of vaccination, 1 882 (45. 1%) children missed routine vaccination. The top three reasons were that the outpatient clinic only had the appointment number but could not make an appointment, the outpatient clinic reduced the daily dose of vaccination, and the outpatient discontinuation. Conclusion The satisfaction of parents of children in Guangzhou with the prevention and control measures of vaccination clinics during the COVID-19 epidemic and after the resumption of vaccination is above the medium level. The COVID-19 epidemic and the suspension of vaccination clinics have a two-way impact on the immunization concept and behavior of parents of children in Guangzhou, and some parents increase their attention to immunization. A small number of parents weakened their emphasis on the timeliness of vaccination, suggesting that vaccination units need to arrange staff and vaccination time reasonably, relieve the pressure on vaccination caused by the backlog of COVID-19 epidemic, carry out targeted positive publicity and guidance, and spread the correct knowledge of vaccination, so as to eliminate the doubts of children's parents. © 2023, Editorial Department of Medical Pest Control. All rights reserved.

Volunteers' perceived preparedness, training, experiences and satisfaction in a mass COVID-19 pandemic vaccine clinic

In this paper, we present formal and informal volunteers' perceived experiences of a mass vaccination clinic for COVID-19 in central Texas. Volunteers at one or more of our team's vaccination events responded to an anonymous survey to share perceptions of their preparedness, training experiences, communication effectiveness and satisfaction, to help us identify opportunities to improve volunteer training and engagement for responses to pandemics. Overall, the volunteers perceived their work to be meaningful, felt prepared and were satisfied with their experiences as volunteers. A dedicated team that communicates well and emphasizes a team approach is key to success, especially in unprecedented situations such as the COVID-19 pandemic. Implications for future volunteer training and involvement in disaster responses are discussed.

Simulation modeling assessment and improvement of a COVID-19 mass vaccination center operations

The development of safe and effective vaccines against COVID-19 has been a turning point in the international effort to control this disease. However, vaccine development is only the first phase of the COVID-19 vaccination process. Correct planning of mass vaccination is important for any policy to immunize the population. For this purpose, it is necessary to set up and properly manage mass vaccination centers. This paper presents a discrete event simulation model of a real COVID-19 mass vaccination center located in Sfax, Tunisia. This model was used to evaluate the management of this center through different performance measures. Three person's arrival scenarios were considered and simulated to verify the response of this real vaccination center to arrival variability. A second model was proposed and simulated to improve the performances of the vaccination center. Like the first model, this one underwent the same evaluation process through the three arrivals scenarios. The simulation results show that both models respond well to the arrival's variability. Indeed, most of the arriving persons are vaccinated on time for all the studied scenarios. In addition, both models present moderate average vaccination and waiting times. However, the average utilization rates of operators are modest and need to be improved. Furthermore, both simulation models show a high average number of persons present in the vaccination center, which goes against the respect of the social distancing condition. Comparison between the two simulation models shows that the proposed model is more efficient than the actual one. [ FROM AUTHOR] Copyright of Simulation is the property of Sage Publications, Ltd. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

How Do People React to COVID-19 Vaccination? A Corpus-Based Study of Macau Netizens' Online Comments

This study draws on corpus methodology to investigate people's reactions to COVID-19 vaccination using the data of Macau netizens' comments on a YouTube channel. Four main topics under discussion were identified based on the word lists. Meanwhile, people were concerned about the activity of vaccines and were also engaged in heated debates on both domestic and foreign vaccines according to the collocation of "疫苗” yìmiáo (vaccine). The discussion topics and concerns varied along with time, evidenced by the results of word lists and collocates of each month. It is also noticeable that some misinformation on vaccines burgeoned and faded before and after the mass vaccination of Macau residents. The supportive voices for the (Chinese) vaccines were building up their momentum over time. This phenomenon lends support to the effective persuasion of gain-framed messages in advocating safe behaviour based on Prospect Theory. Our research has revealed that the corpus-based study of online comments can be leveraged to uncover people's social behaviour in the pandemic context. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Microneedles: An Emerging Vaccine Delivery Tool and a Prospective Solution to the Challenges of SARS-CoV-2 Mass Vaccination.

Vaccination is an effective measure to prevent infectious diseases. Protective immunity is induced when the immune system is exposed to a vaccine formulation with appropriate immunogenicity. However, traditional injection vaccination is always accompanied by fear and severe pain. As an emerging vaccine delivery tool, microneedles overcome the problems associated with routine needle vaccination, which can effectively deliver vaccines rich in antigen-presenting cells (APCs) to the epidermis and dermis painlessly, inducing a strong immune response. In addition, microneedles have the advantages of avoiding cold chain storage and have the flexibility of self-operation, which can solve the logistics and delivery obstacles of vaccines, covering the vaccination of the special population more easily and conveniently. Examples include people in rural areas with restricted vaccine storage facilities and medical professionals, elderly and disabled people with limited mobility, infants and young children afraid of pain. Currently, in the late stage of fighting against COVID-19, the main task is to increase the coverage of vaccines, especially for special populations. To address this challenge, microneedle-based vaccines have great potential to increase global vaccination rates and save many lives. This review describes the current progress of microneedles as a vaccine delivery system and its prospects in achieving mass vaccination against SARS-CoV-2.

Key Lessons from COVID-19: A Narrative Review Describing Qatar's Multifactorial Approach in Executing a Vaccination Campaign.

Widespread vaccination programs have been implemented in many countries to curtail the COVID-19 pandemic, with varying success and challenges. To better understand the successes and challenges of the global COVID-19 response in the face of emerging new variants and epidemiologic data, we discuss how Qatar engaged the healthcare sector, governmental bodies, and the populace to combat COVID-19, with a focus on the country's vaccination strategy. This narrative provides the history and timeline of the Qatar COVID-19 vaccination campaign; factors that helped the vaccination campaign and the transferable lessons learned are discussed. Details regarding how Qatar responded to challenges, such as vaccine hesitancy and mitigation of misinformation, are highlighted. Qatar was one of the first countries to procure the BNT162b2 (Comirnaty®; Pfizer-BioNTech, Pfizer Inc., New York, NY, USA) and mRNA-1273 (Spikevax®; Moderna, Cambridge, MA, USA) COVID-19 vaccines. A relatively high vaccination rate and low case mortality rate (0.14% as of 4 January 2023) was observed in Qatar compared with other countries (global case mortality rate, 1.02%). Learnings will be carried forward as a basis for addressing this evolving pandemic and any future national emergencies in Qatar.

Pharmacovigilance of the effects associated with vaccination against SARS-CoV-2 in the health personnel of a hospital for the exclusive care of patients with COVID-19

The Pablo Arturo Suárez Hospital, located in Quito, the capital of Ecuador, became an exclusive care hospital for COVID-19 patients in March 2020. It was one of the first centers to immunize its staff with a single type of vaccine, that of Pfizer-BioNTech. A pharmacovigilance study was conducted on 1304 health workers from this center who were immunized between January and March 2021. The vaccinated had an average age of 38.7 years, and the female sex predominated (63%). 81 (6%) immunized reported adverse effects, and their mean age was 38.8 years;women (69%) predominated, similar to the total population. Three hundred five adverse effects related to vaccines were reported;of them, only 1 (0.3%) was severe and required hospitalization, and the rest (23%) were non-serious. The most reported effects were headache, malaise, and pain at the injection site. The results show a parallel with what has been said worldwide on the safety of vaccines against COVID-19 in general and Pfizer-BioNTech in particular. The relevance of our work lies in the fact that it is one of the first reports of the reactogenicity of this vaccine in a high-altitude city at the beginning of the pandemic, in a court of health personnel directly dedicated to the care of this type of patient. Copyright: © 2022 by the authors.

Setting up the Largest Mass Vaccination Center in Europe: The One-Physician One-Nurse Protocol.

To manage mass vaccination without impacting medical resources dedicated to care, we proposed a new model of Mass Vaccination Centers (MVC) functioning with minimum attending staffing requirements. The MVC was under the supervision of one medical coordinator, one nurse coordinator, and one operational coordinator. Students provided much of the other clinical support. Healthcare students were involved in medical and pharmaceutical tasks, while non-health students performed administrative and logistical tasks. We conducted a descriptive cross-sectional study to describe data concerning the vaccinated population within the MVC and the number and type of vaccines used. A patient satisfaction questionnaire was collected to determine patient perception of the vaccination experience. From 28 March to 20 October 2021, 501,714 vaccines were administered at the MVC. A mean rate of 2951 ± 1804 doses were injected per day with a staff of 180 ± 95 persons working every day. At peak, 10,095 injections were given in one day. The average time spent in the MVC was 43.2 ± 15 min (time measured between entry and exit of the structure). The average time to be vaccinated was 26 ± 13 min. In total, 4712 patients (1%) responded to the satisfaction survey. The overall satisfaction with the organization of the vaccination was 10 (9-10) out of 10. By using one attending physician and one nurse to supervise a staff of trained students, the MVC of Toulouse optimized staffing to be among the most efficient vaccination centers in Europe.

Evaluating a Covid-19 Vaccine Centre in the UK Using a DES Model

Efficient management of a Covid-19 vaccine centre (VC) is necessary for proper-functioning of a mass vaccination programme. This study reports on an evaluation of the operational performance of a VC. There are two key considerations: the VC capacity (patients per hour) and the patient flow-time (total time patients spent in the centre). In this paper, Witness Horizon a simulation model tool that can be used to enhance the effectiveness of vaccination facilities is introduced. The model is developed using discrete event simulation. The model utilises animation whilst dynamically displaying key performance indicators. The uniqueness of this approach is the ability to simulate and analyse VC scenarios stochastically by varying hourly arrivals, walk-ins to drive-in ratios, staffing levels, registration, immunization, and observation capacities. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

The whole-of-society approach of mass COVID-19 vaccination in China: a qualitative study.

BACKGROUND: Many countries have an inefficient vaccination system, which hinders global exit from the COVID-19 pandemic. It is vital to summarize COVID-19 vaccination practices in countries with high vaccination coverage and provide implications for other countries. This study aimed to investigate China's COVID-19 vaccination system and to summarize its implementation experience from a health system perspective. METHODS: We conducted key informant interviews in five representative cities of China in late 2021. Guided by the health systems framework proposed by WHO, we developed our interview guidelines which included seven building blocks-leadership and governance, health workforce, vaccination service delivery, vaccination mobilization and communication, financing, access to vaccines, and information systems. Semi-structured interviews and COVID-19 vaccination policy documents were collected and coded using a thematic analysis approach. RESULTS: A total of 61 participants (nine vaccination programme directors of the local Center for Disease Control and Prevention, four government staff and 48 vaccination service workers) were interviewed. We found that China adopted a whole-of-society approach with adequate government engagement and linked health and non-health sectors to promote COVID-19 vaccination. Key measures included the collaboration of multiple systems and departments from a governance perspective, allocating sufficient health workers and resources, large-scale vaccination mobilization and communication, expansion of vaccine financing channels, localized production and digital information systems. With the vaccination system strengthening, the two-doses vaccination coverage reached 89.5% for the total population but relatively lower coverage for older adults as of July 2022. CONCLUSIONS: Our study highlights the importance of a government-led whole-of-society approach to promote mass vaccination. The low vaccination coverage among older adults should be paid the greatest attention to. The experiences and lessons from China may serve as a reference for other countries.

Mass Immunizations: A Pocket Guide.

Numerous state, national, and global resources exist for planning and executing mass vaccination campaigns. However, they are disparate and can be complex. The COVID-19 pandemic highlighted the need for clear, easy to use mass vaccination resources. Meanwhile, annual influenza vaccination, as well as outbreaks such as mpox, demonstrates the need for continued emphasis on timely and effective vaccinations to mitigate outbreaks. This pocket guide seeks to combine relevant resources and basic steps for setting up a mass vaccination clinic, utilizing experience from COVID-19 mass vaccination sites.

Identification of Key Factors for Optimized Health Care Services: Protocol for a Multiphase Study of the Dubai Vaccination Campaign.

BACKGROUND: Mass vaccination of the global population against the novel COVID-19 outbreak posed multiple challenges, including effectively administering millions of doses in a short period of time while ensuring public safety and accessibility. The government of Dubai launched a mass campaign in December 2020 to vaccinate all its citizens and residents, targeting the population aged >18 years against COVID-19. The vaccination campaign involved a transformation of multiple commercial spaces into mass vaccination centers across the city of Dubai, the largest of which was the Dubai One Central (DOC) vaccination center. It was operational between January 17, 2021, and 27 January 27, 2022. OBJECTIVE: The multiphase research study aims to empirically explore the opinions of multiple health care stakeholders, elicit the key success factors that can influence the effective delivery of emergency health care services such as a COVID-19 mass vaccination center, and explore how these factors relate to one another. METHODS: To understand more about the operations of the DOC vaccination center, the study follows a multiphase design divided into 2 phases. The study is being conducted by the Institute for Excellence in Health Professions Education at Mohammed Bin Rashid University of Medicine and Health Sciences between December 2021 and January 2023. To elicit the key success factors that contributed to the vaccination campaign administered at DOC, the research team conducted 30 semistructured interviews (SSIs) with a sample of staff and volunteers who worked at the DOC vaccination center. Stratified random sampling was used to select the participants, and the interview cohort included representatives from the management team, team leaders, the administration and registration team, vaccinators, and volunteers. A total of 103 people were invited to take part in the research study, and 30 agreed to participate in the SSIs. To validate the participation of various stakeholders, phase 2 will analytically investigate one's subjectivity through Q-methodology and empirically investigate the opinions obtained from the research participants during phase 1. RESULTS: As of July 2022, 30 SSIs were conducted with the research participants. CONCLUSIONS: The study will provide a comprehensive 2-phase approach to obtaining the key success factors that can influence the delivery of high-quality health care services such as emergency services launched during a global pandemic. The study's findings will be translated into key factors that could support designing future health care services utilizing evidence-based practice. In line with future plans, a study will use data, collected through the DOC vaccination center, to develop a simulation model outlining the process of the customer journey and center workflow. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/42278.

Using DES to Improve the Efficiency of a Covid-19 Vaccination Centre

Many research and development teams around the world have developed and continue to improve Covid-19 vaccines. As vaccines are produced, preparedness and planning for mass vaccination and immunization has become an important aspect of the pandemic management. Mass vaccination has been used by public health agencies in the past and is a viable option for Covid-19 immunization. To be able to rapidly and safely immunize a large number of people against Covid-19, mass vaccination centres are accessible in the UK. Careful planning of these centres is a difficult and important job. Two key considerations are the capacity of each centre (measured as the number of patients served per hour) and the time (in minutes) spent by patients in the centre. This paper discusses a simulation study done to support this planning effort. In this paper, we explore the operations of a vaccination centre and use a simulation tool to enhance patient flow. The discrete event simulation (DES) tool outputs visually and numerically show the average and maximum patient flow times and the number of people that can be served (throughput values) under different number of patient arrivals (hourly). With some experimentation, the results show that marginally reducing the hourly arrival rate, patient congestion reduces enabling good patient service levels to be achieved. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

Analysis of Strategies to Tackle the Environmental Impact of the Vaccine Supply Chain: A Fuzzy DEMATEL Approach

To combat the COVID-19 pandemic, the scientific community has progressed from discovering antivirals to the large-scale production of vaccines. Mass vaccination programs to curb the COVID-19 pandemic started in many parts of the world at the beginning of 2021. Mass vaccination aims to exit from health emergencies by vaccinating all the population with the required dose in the shortest possible time. The production rate has been boosted, and many new production facilities have been opened to fulfill worldwide demand. The objective of the vaccination program is to maximize the medical benefit with the lowest cost and equitable distribution of vaccines worldwide. However, the environmental impact of this long-run immunization program has received very little attention. This study explores the environmental impact of the vaccine supply chain (VSC) and analyzes the mitigation strategies to minimize it without affecting the medical, economic, and social benefits of vaccination. The fuzzy DEMATEL technique has been used to prioritize the mitigation techniques and find cause and effect relations among them. The finding of studies shows that the "optimal vial design” is most important, and "vaccine awareness and education” is the most impactful strategy to tackle the environmental impact of VSC. © 2023, The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.

THE PRACTICAL GUIDANCE ON IMMUNIZATION OF WAR REFUGEES FROM UKRAINE.

Implementation of national vaccination programme as well as providing catch-up immunization schedule for war refugees from Ukraine is a challenge for Polish primary care physi-cians. Measles, mumps, rubella, polio and COVID-19 catch-up vaccinations are considered a priority. The Ukrainian Immunization Programme is similar to the Polish one, but it does not include vaccination against pneumococcal disease and rotavirus. Moreover there are differences between Ukrainian and Polish vaccination schedules against pertussis, polio and Haemophilus influenzae. In this article we present principles and practical guidelines for preparing catch-up immunization schedules for refugees from Ukraine, as well as a list of vaccine preparations available in Ukraine and their Polish equivalents. For preparations available only in Ukraine, a vaccine with the most similar composition was proposed.Copyright © 2022, Wydawnictwo Czelej Sp. z o.o.. All rights reserved.

How will mass-vaccination change COVID-19 lockdown requirements in Australia?

Background To prevent future outbreaks of COVID-19, Australia is pursuing a mass-vaccination approach in which a targeted group of the population comprising healthcare workers, aged-care residents and other individuals at increased risk of exposure will receive a highly effective priority vaccine. The rest of the population will instead have access to a less effective vaccine. Methods We apply a large-scale agent-based model of COVID-19 in Australia to investigate the possible implications of this hybrid approach to mass-vaccination. The model is calibrated to recent epidemiological and demographic data available in Australia, and accounts for several components of vaccine efficacy. Findings Within a feasible range of vaccine efficacy values, our model supports the assertion that complete herd immunity due to vaccination is not likely in the Australian context. For realistic scenarios in which herd immunity is not achieved, we simulate the effects of mass-vaccination on epidemic growth rate, and investigate the requirements of lockdown measures applied to curb subsequent outbreaks. In our simulations, Australia's vaccination strategy can feasibly reduce required lockdown intensity and initial epidemic growth rate by 43% and 52%, respectively. The severity of epidemics, as measured by the peak number of daily new cases, decreases by up to two orders of magnitude under plausible mass-vaccination and lockdown strategies. Interpretation The study presents a strong argument for a large-scale vaccination campaign in Australia, which would substantially reduce both the intensity of future outbreaks and the stringency of non-pharmaceutical interventions required for their suppression. Funding Australian Research Council; National Health and Medical Research Council.

COVID-19 VACCINATION, GOVERNMENT STRICT POLICY AND CAPITAL MARKET VOLATILITY: EVIDENCE FROM ASEAN COUNTRIES

The COVID-19 pandemic had a negative impact on the volatility of the stock market in the ASEAN region. Mass vaccination and strictness policies are government efforts to tackle stock market losses. Hence, this study aims to examine the effect of the COVID-19 vaccination and the stringent government policies on the volatility of stock markets in ASEAN countries. We collected the daily index prices, the number of vaccines, and the stringency index from 13 January 2020 to 31 August 2021. Using the GJR-GARCH model (1, 1) and Generalized Least Square regression, this study found that the mass vaccination had a negative effect on stock market volatility, whereas the government's stringent policies had a positive effect. Mass vaccination tends to increase the confidence of economic actors, impacting investors' confidence in the stability of the stock market. Meanwhile, the government's strict policies have caused uncertainty among economic actors and investors regarding the economic prospects during the pandemic, leading to high levels of volatility. Therefore, governments must promote more aggressive vaccination policies, thereby reducing stringent policies for economic agents. © 2023, Bulgarska Akademiya na Naukite. All rights reserved.

The role of the mass vaccination programme in combating the COVID-19 pandemic: An LSTM-based analysis of COVID-19 confirmed cases.

The COVID-19 virus has impacted all facets of our lives. As a global response to this threat, vaccination programmes have been initiated and administered in numerous nations. The question remains, however, as to whether mass vaccination programmes result in a decrease in the number of confirmed COVID-19 cases. In this study, we aim to predict the future number of COVID-19 confirmed cases for the top ten countries with the highest number of vaccinations in the world. A well-known Deep Learning method for time series analysis, namely, the Long Short-Term Memory (LSTM) networks, is applied as the prediction method. Using three evaluation metrics, i.e., Mean Absolute Error (MAE), Root Mean Square Error (RMSE), and Mean Absolute Percentage Error (MAPE), we found that the model built by using LSTM networks could give a good prediction of the future number and trend of COVID-19 confirmed cases in the considered countries. Two different scenarios are employed, namely: 'All Time', which includes all historical data; and 'Before Vaccination', which excludes data collected after the mass vaccination programme began. The average MAPE scores for the 'All Time' and 'Before Vaccination' scenarios are 5.977% and 10.388%, respectively. Overall, the results show that the mass vaccination programme has a positive impact on decreasing and controlling the spread of the COVID-19 disease in those countries, as evidenced by decreasing future trends after the programme was implemented.

Seasonality, mass vaccination and critical policy evaluation on global exit strategy of COVID-19 crisis.

There is a strong coordinated effort by vaccination groups all over the world to put an end to the current crisis of COVID-19. Now sufficient data are available to analyse and compare some results to explore the aftereffects of vaccination. Some influence variables on transmissions of the disease were discussed e.g., mass vaccination, lockdown and seasonality. Most studies covered here are up to the beginning of July 2022, while some analyses focused on the earlier period of mass vaccination. Well established, simple statistical techniques to evaluate results were presented those used open data sources of authoritative bodies. Some comparisons between vaccinated vs. unvaccinated were also discussed based on data from UK Government Health Security Agency (UHSA). In terms of mass vaccination, adverse reactions after vaccination received attention, as health and safety issues of the general public are of prime importance. Apart from direct side effects, the secondary effect of mass vaccination needs attention too. After the initiation of the vaccination programme, almost all countries experienced a sudden surge in transmission and most countries had to impose strict lockdown measures. Many countries, with a low prevalence of disease, suddenly showed a steep jump and some countries even followed a synchronized pattern between the rate of transmissions and the variation of vaccine doses. Time series analyses and bar diagram presentations were able to capture those features. In that context, fast mutation of the virus and new variants after mass vaccination and possible mechanisms/consequences were also attended. To understand the effect of seasonality, similarities between COVID-19 and the seasonal Flu are discussed for Europe and US to gain useful insight. Using time series analyses and spatial plots of regional temperature composites we showed, like Flu, seasonality played a dominant role in transmissions of COVID-19 in the Europe. Regulations of vaccine dose and policy implication were explored too. From 22nd December 2021, global vaccine doses were reduced substantially, which followed a dramatic reduction in cases and thereafter deaths with around one month's lag between each. As strong dependency on seasonality is noticed in certain countries and observing that regulation of vaccine doses has roles in modulating the transmission with certain lags, globally as well as regionally, our results have policy implications for the management of COVID. Debating, questioning and criticism are always the foundation of great science and the major pillars of its progress. Following that objective, it is an effort to explore pragmatically, supported by scientific analyses, areas relating to the effectiveness of the COVID-19 vaccine and the exit strategy via the pathway of vaccination.